Abstract

Objective: Monitoring of intracranial pressure (ICP) is a routine procedure in the neurosurgery field. Although the routine practice of monitoring ICP has decreased in recent years, the practice patterns have not been studied in Colombia. This study was designed to evaluate the current practice forventriculostomy ...
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Objective: Monitoring of intracranial pressure (ICP) is a routine procedure in the neurosurgery field. Although the routine practice of monitoring ICP has decreased in recent years, the practice patterns have not been studied in Colombia. This study was designed to evaluate the current practice forventriculostomy and ICP monitoring by neurosurgeons in Colombia.
Methods: An 11-question electronic survey was delivered to 380 practicing neurosurgeons.Demographic information and rates of proper ventriculostomy placement for monitoring of ICP were described.
Results:Fifty-one percent of practicing neurosurgeons responded to the survey (response rate 13.4%). The rate of successful cannulation of the ipsilateral ventricle ranged from 70% to 100%.
Conclusion:This survey shows that Colombian neurosurgeons have similar tendencies to
other developed countries. Prospective studies are necessary to establish actual evidence-based practices

Abstract

Objective: The scale of the problem of poisoning is enormous hence clinico epidemiological spectrum of all poisoning cases need to explore to generate the management tool.
Methods: This prospective study was done at two medicine units (Unit 5 and 10) of Dhaka Medical College Hospital from July ...
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Objective: The scale of the problem of poisoning is enormous hence clinico epidemiological spectrum of all poisoning cases need to explore to generate the management tool.
Methods: This prospective study was done at two medicine units (Unit 5 and 10) of Dhaka Medical College Hospital from July to December 2010 where all poisoning cases were seen. A total of 2890 patients were admitted out of which 600 were taken into the study.
Results: Among the poisoning cases 29% were pesticide, 27% travel related poisoning, and 20% benzodiazepine. 70% of poisoning occurred below 30 years of age and male: female ratio was 3:2. Incidence of poisoning was highest among students (31%) and housewives (25%). Majority of the patients were from urban area (76%) and most common intention was suicidal (66%). Familial disharmony was the prime cause (63%) behind poisoning. 42% cases got admitted between 5-8 hours of poisoning and more than 80% patients were admitted in the hospital directly without getting any first aid anywhere. Sixty-eight percent had Glasgow coma scale (GCS) score above 10 during admission. Cardinal clinical features of poisoning were nausea/vomiting (63%), drowsiness (56%), miosis (31%). Seventy percent patients were treated with only general and supportive treatment and specific antidotes were used in 30% cases. Case fatality for pesticide, benzodiazepine/anti-psychotic, rodenticide and snake bite was 6.9%, 2.2%, 8.3% and 3.3% respectively.
Conclusion: To assess the magnitude of problem, awareness of the public for prevention, immediate first aid measures and quick hospital admission is crucial component of poisoning.

Abstract

Objective: Thoracic trauma may be a life-threatening condition. Flail chest is a severe chest injury with high mortality rates. Surgery is not frequently performed and, in Literature, data are controversial. The authors report their experience in the treatment of flail chest by an extracortical internal-external ...
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Objective: Thoracic trauma may be a life-threatening condition. Flail chest is a severe chest injury with high mortality rates. Surgery is not frequently performed and, in Literature, data are controversial. The authors report their experience in the treatment of flail chest by an extracortical internal-external stabilization technique with Kirshner’s wires (K-wires).
Methods: From 2010 to 2015, 137 trauma patients (109 males and 28 females) with an average age of 58.89 ±19.74 years were observed. Seventeen (12.41%) patients presented a flail chest and of these, 13 (9.49%) with an anterior one. All flail chest patients underwent early chest wall surgical stabilization (within 48 hours from the injury).
Results: In the general population, an overall morbidity of 21.9% (n = 30 of 137) and a 30-day mortality rate of 5.1% (n = 7 of 137) were observed. By clustering the population according to the treatment (medical or interventional vs surgical), significant statistically differences between the two cohorts were found in morbidity (12.65% vs. 34.48%, P = 0.002) and mortality rates (1.28% vs. 10.34%, P = 0.017). In patients undergoing chest wall surgical stabilization, with an average Injury Severity Score of 28.3 ± 5.2 and Abbreviated Injury Score (AIS) of 8.4 ± 1.7, an overall morbidity rate of 52.9% (n = 9) and a mortality rate of 17.6% (n = 3) were found. Post-surgical device removal, in local anesthesia or mild sedation, was performed 42.8 ± 2.9 days after chest wall stabilization and no cases of wound infection, dislodgment of the wires or osteosynthesis failure were reported. Moreover, in these patients, an early postoperative improvement in pulmonary ventilation (ΔpaO2 and ΔpCO2: +9.49 and -5.05, respectively) was reported.
Conclusion: Surgical indication for the treatment of flail chest remains controversial and debated both due to an inadequate training and the absence of comparative prospective studies between various strategies. Our technique for the surgical treatment of the anterior flail chest seems to be anachronistic, but the aspects described, both in terms of technical features and of outcome and benefits (health, economic), allow to evaluate the effectiveness of this approach.

Abstract

Objective: Scorpion is one of the world’s most venomous arthropods and every year many people are bitten by it. In Iran, scorpion sting is a common health issue. The aim of this study was to evaluate the epidemiological and clinical status of patients with scorpion sting in the emergency department ...
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Objective: Scorpion is one of the world’s most venomous arthropods and every year many people are bitten by it. In Iran, scorpion sting is a common health issue. The aim of this study was to evaluate the epidemiological and clinical status of patients with scorpion sting in the emergency department of Sina hospital in 2014.
Methods: In this descriptive cross-sectional study, all patients with a history of scorpion sting during 2014 in the emergency department of Sina hospital in Tabriz entered the study. Required information such as sex, age, location and time of the sting, the patient’s symptoms, etc were extracted from the medical records. These findings were analyzed using SPSS version 15.
Results: Based on our results, 47.2% of patients were male. The mean ± SD of their age was 35.63 ± 18.87. Of 176 patients, 83% lived in urban areas, 87% of scorpion sting cases occurred in houses, and 81.3% of stings were done by yellow scorpion. Most of the bites were in upper extremities (47.2%). In evaluation of symptoms and signs of patients, 89.8% had pain, 48.8% had local erythema and redness, 21% had inflation of sting position and 0.6% had pulmonary symptoms.
Conclusion: Scorpion stings are more common in young people as they are more active. Scorpion stings occur more frequently during the night and in the summer. In our study, most of scorpion stings occurred in houses.

Abstract

Objective: Cardiopulmonary resuscitation (CPR) has been known in its present form since 1960. Different studies have reported variable outcomes among different countries. Therefore, the purpose of this study was to assess the rate of CPR success and the survival rate in managing cardiac arrest among ...
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Objective: Cardiopulmonary resuscitation (CPR) has been known in its present form since 1960. Different studies have reported variable outcomes among different countries. Therefore, the purpose of this study was to assess the rate of CPR success and the survival rate in managing cardiac arrest among patients in an educational medical center.
Methods: This cross-sectional study was performed at Imam Hosein hospital, Tehran, Iran. All patients, admitted to the emergency department with cardiac arrest between March 2007 and January 2008 were included. We used a formerly designed registration form and hospital documentation to retrieve the data of included patients. The main outcomes were the rate of CPR success and the survival rate of these patients.
Results: Totally 855 patients were included, from which 510 (59.64%) were males. The mean age of included patients was 63 ± 17.6. The CPR process was successful among 364 (42.58%) patients. A total number of 101 (11.82%) patients were discharged from the hospital. Different factors as the cause of cardiac arrest and past medical problems affected the probability of CPR success and the survival of patients with cardiac arrest.
Conclusion: Survival rate at hospital discharge was less than one-third of patients and nearly half of the patients received successful CPR. More intensive care unit (ICU) facilities and educational interventions for the emergency staff and the community can enhance the survival of cardiac arrest patients in our health system.

Abstract

Objective: According to the definition of World Health Organization (WHO), attempting suicide is an act that a person intentionally and without others’ interference shows an abnormal behavior (such as harming themselves or eating a drug higher than treatment dose) and his objective is realizing ...
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Objective: According to the definition of World Health Organization (WHO), attempting suicide is an act that a person intentionally and without others’ interference shows an abnormal behavior (such as harming themselves or eating a drug higher than treatment dose) and his objective is realizing his expected changes. The purpose of this study was to investigate the demographic characteristics of married women with suicidal attempt and a variety of methods used to suicide among them who referred to the emergency department of Sina hospital in Tabriz.
Methods: In a cross-sectional study 472 married female patients with suicide attempt who referred to the emergency department of Sina hospital in Tabriz in 2014 entered the study and relevant information was collected. Obtained information was analyzed using SPSS version 17.0.
Results: Findings showed that the most frequent method of suicide was drug use (99.8%). A significant relationship was found between the type of drug used and seasons of the year. The majority of the population (90.5%) lived in urban areas and based on statistical analyses, a significant relationship was found between residency and type of drug used.
Conclusion: According to the results of this study it can be concluded that drug use is the most frequent method of suicide that is done with a higher frequency in summer. Thus, rational prescription of drugs by physicians can be considered as one of the factors that can prevent suicide.

Abstract

We report a 54-year-old woman with the history of end-stage renal disease (ESRD) who was admitted to our hospital because of volume overload. Due to long-term use of peripheral veins and arteriovenous fistula (AVF) failure, central venous catheterization was the only choice for hemodialysis. She developed ...
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We report a 54-year-old woman with the history of end-stage renal disease (ESRD) who was admitted to our hospital because of volume overload. Due to long-term use of peripheral veins and arteriovenous fistula (AVF) failure, central venous catheterization was the only choice for hemodialysis. She developed right upper extremiti’s pain and paresis during hemodialysis. A posteroanterior chest x-ray showed the catheter tip was accidently pushed from right internal jugular vein into right subclavian vein during hemodialysis by the dialysis center nurse. Therefore, we believe that the physician should be aware of any changes in the catheter size after insertion. And a chest x-ray should ensure the catheter’s correct position in any patient who develops complications.

Abstract

The first time Weinstein in 1982 described patients with the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP) in pregnant preeclamptic and eclamptic patients. This syndrome is a severe form of preeclampsia or eclampsia. Usually HELLP syndrome occurs at the third trimester ...
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The first time Weinstein in 1982 described patients with the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP) in pregnant preeclamptic and eclamptic patients. This syndrome is a severe form of preeclampsia or eclampsia. Usually HELLP syndrome occurs at the third trimester and only 15% occur before the 27th week of pregnancy and rarely before the 20th week of pregnancy. We want to present a 30- year old parity 2, gravidity 1 pregnant patient who was pregnant for 20 weeks with preeclampsia and HELLP syndrome. Two hours before arriving to the emergency unit, she felt chest discomfort and went to the nearest clinic to visit a physician. She was then referred to the hospital because of high blood pressure (BP). When she arrived to the emergency unit, she had right upper quadrant and epigastric pain, headache, vomiting, dyspnea, and high BP (185/100). Finally the diagnosis of HELLP syndrome was made. As maternal and fetus mortality and morbidity of HELLP syndrome is high, immediate recognition and treatment is vital to save the lives of both the mother and the fetus.

Abstract

Oculocardiac reflex (OCR) sometimes occurs as a result of pressure on the eye or traction of the intraorbital surrounding structures during ophthalmic surgery. This can result in bradycardiac arrhythmia and cardiac arrest. A 45-year-old female was undergoing an elective squint correction surgery of one ...
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Oculocardiac reflex (OCR) sometimes occurs as a result of pressure on the eye or traction of the intraorbital surrounding structures during ophthalmic surgery. This can result in bradycardiac arrhythmia and cardiac arrest. A 45-year-old female was undergoing an elective squint correction surgery of one eye under local anaesthesia in a private hospital in December 2013. The patient was preoperatively examined, investigated and admitted to the hospital one day prior to operation. There was no previous history of any chronic illnesses. The patient collapsed during surgery and declared dead. Doctors attempting strabismus surgery under local anaesthesia should be familiar with this phenomenon.